1437153038 NPI number — CITY OF LAWRENCE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437153038 NPI number — CITY OF LAWRENCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF LAWRENCE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LAWRENCE DOUGLAS COUNTY FIRE MEDICAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437153038
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1911 STEWART AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66046-2516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-830-7000
Provider Business Mailing Address Fax Number:
785-830-7090

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1911 STEWART AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-830-7000
Provider Business Practice Location Address Fax Number:
785-830-7090
Provider Enumeration Date:
06/10/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COFFEY
Authorized Official First Name:
SHAUN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
INTERIM FIRE CHIEF
Authorized Official Telephone Number:
785-830-7000

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  995 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100273470-A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 119992 . This is a "BC BS OF KANSAS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 590010886 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".